A patient is described in whom primary cardiac sarcoma preferentially infiltrated the ventricular septum while essentially sparing the left ventricular free wall, resulting in striking echocardiographic and morphologic asymmetry between septum and free wall ("ASH"). No reports have appeared previously of a patient with an intramural cardial neoplasm demonstrated by echocardiogram. Additionally, the patient clinically had features typical of coronary heart disease, but yet at necropsy the extramural coronary arteries showed insignificant luminal narrowing by atherosclerotic plaques.